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An international taxonomy for errors in general practice: a pilot study
Meredith A B Makeham1, Susan M Dovey, Mary County
1Department of General Practice, University of Sydney, 37a Booth Street, Balmain, NSW 2041, Australia. makeham@ozemail.com.au
Objectives:
To develop an international taxonomy describing errors reported by general practitioners in Australia and five other countries.
Design And Setting:
GPs in Australia, Canada, the Netherlands, New Zealand, the United Kingdom and the United States reported errors in an observational pilot study. Anonymous reports were electronically transferred to a central database. Data were analysed by Australian and international investigators.
Participants:
Non-randomly selected GPs: 23 in Australia, and between 8 and 20 in the other participating countries.
Main Outcome Measures:
Error categories, and consequences.
Results:
In Australia, 17 doctors reported 134 errors, compared with 301 reports by 63 doctors in the other five countries. The final taxonomy was a five-level system encompassing 171 error types. The first-level classification was "process errors" and "knowledge and skills errors". The proportion of errors in each of these primary groups was similar in Australia (79% process; 21% knowledge and skills) and the other countries (80% process; 20% knowledge and skills). Patient harm was reported in 32% of reports from Australia and 30% from other countries. Participants considered the harm "very serious" in 9% of Australian reports and 3% of other countries' reports.
Conclusions:
This pilot study indicates that errors are likely to affect primary care patients in similar ways in countries with similar primary healthcare systems. Further comparative studies are required to improve our understanding of general practice error differences between Australia and other countries.